Ewing's sarcoma. A light- and electron-microscopic study of 21 cases

Twenty-one cases of Ewing's sarcoma were analyzed by light- and electron-microscopy and the fine structure compared to that described in previous publications. In the predominant "primary" tumor cells, glycogen was abundant in 53% of cases, infrequent in 33%, and rare in 14%. In three cases, microtubules, in association with glycogen, were demonstrated. The so-called differentiated "secondary" reticular tumor cells were sparsely populated in eight cases. Evidence is presented to suggest that these so-called "secondary" reticular cells are merely "primary" tumor cells in a state of regression. Secondary cells and cells with nuclear identations or convolutions were of no discernible prognostic significance. The histogenesis of Ewing's sarcoma remains an enigma but present findings support a primitive mesenchymal origin.